Myra Powers Email & Phone Number

Ucare

• Provide review of medical documentation against criteria requirement for the purposes of determining coverage of select services for medical necessity, and approval of coverage when criteria is met
• Claims adjustments, provider education, provider grievance resolution along with the use of multiple computer systems, and ongoing education of Medicare and Medicaid criteria
• Review initial and concurrent requests for hospital and skilled nursing home admissions through dischargeAugust 2010 – April 2012: Restricted Recipient Nurse, UCareo Promoted to temporary position as a case manager.

Minneapolis, MN

• Produce clinical summaries of medical records and provided expert opinion regarding causation
• Create exhibits for trial, created demand letters and negotiated claims
• Improved process for screening/interviewing clients reducing time spent on non-meritorious cases
• Optimize current software capabilities to reduce medical record search and lobbied outsourced vendor to integrate additional research data bases

• August 2004 – September 2006: Epic Support Staff Nurse, Codeblue Medical Staffing, Minneapolis, Minnesota
• Hired by Health Partners to assist with their transitional phase to electronic medical records (EMR)
• Trained on-site medical staff to utilize EpicCare with charting, billing and system communications
• Role required to assist physicians, providers and nursing staff at all clinic locations with patients and procedures
• Worked in conjunction with a multitude of language translators due to our diverse patient populations

• Hired by Health Partners to assist with their transitional phase to electronic medical records (EMR)
• Trained on-site medical staff to utilize EpicCare with charting, billing and system communications
• Role required to assist physicians, providers and nursing staff at all clinic locations with patients and procedures
• Worked in conjunction with a multitude of language translators due to our diverse patient populations

Subcontracted to perform independent case review and analysis. Responsibilities included review of medical records and submission of a written summary and analysis of pertinent medical findings. This process required but was not limited to determine medical necessity and relevance to surgical and medical intervention resulting in subsequent effective.

• Conducted on-site medical chart review for external audit in accordance with the NCQA
• Chart audit and submission of copies of any significant findings to inquiring health plans- A submission of daily data reports and e-mail communications with the Hedis
• Personally was selected as the Minnesota representative for Q-Mark Hedisheip, but due to lack of full-time employment guarantee, I declined 2005-2007 audit position

• Primary role was to provide direct assistance to clinic OB/GYN physicians
• Responsibilities included the following: completion of patient history, patient education, and preparations of rooms for procedures and medical procedures, and administration of injections
• Additionally, responsible for scheduling surgeries, medical procedures, phone triage and preparing patient charts for provider review. e to a difficult pregnancy.

As, Nursing

Activities and Societies: Phi Theta Kappa Working toward my AS degree in Nursing through the Mobility program at NHCC with a anticipated.

Nursing Diploma, Nursing

Activities and Societies: Graduated in 1998 with a 3.82 GPA